Active NPI
Pinnacle Health Group PA
- Internal Medicine Physician
- Tampa, FL
National Provider Identifier
1023004231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME71925
- Legal business name
- PINNACLE HEALTH GROUP PA
- Practice address
- 2605 W Swann Ave
Ste 100
Tampa, FL 33609-4039 - Phone
- (813) 874-5500
- Fax
- (813) 874-5505
- NPI assigned
- Sep 22, 2005
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Sam Diasti, MD
- Title
- President
- Phone
- (813) 874-5500
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 14
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Tampa, FL
- NPI 1659477305
FL
-
- Registered Dietitian
- Tampa, FL
- NPI 1033494612
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0973604 | Pinnacle Health Group | Certificate of waiver | May 9, 2028 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041213000732 | FL | Part B Supplier - Clinic/Group Practice | 6507823440 |
Receives reassigned benefits from 10 practitioners Practice locations: Tampa, FL |
National Provider Directory
National Provider DirectoryLocations
1601 W Reynolds St
Ste 201
Plant City, FL 33563
Phone (813) 874-5500
3117 W Gandy Blvd
Tampa, FL 33611
Phone (813) 261-5500
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME71925 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
2605 W Swann Ave
Ste 100
Tampa, FL 33609-4039
Mailing address
PO Box 18344
Tampa, FL 33679-8344
Phone (813) 874-5500
Other practice location 1
1601 W Reynolds St Ste 201
Plant City, FL 33563-4747
Phone (813) 874-5500
Electronic endpoints 1
NPPES NPI Registry| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | TAMPA | Direct |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 31, 2022.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648684800000",
"number": "1023004231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18344",
"city": "TAMPA",
"state": "FL",
"postal_code": "336798344",
"telephone_number": "813-874-5500",
"fax_number": "813-874-5505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 W SWANN AVE",
"address_2": "STE 100",
"city": "TAMPA",
"state": "FL",
"postal_code": "336094039",
"telephone_number": "813-874-5500",
"fax_number": "813-874-5505"
}
],
"practiceLocations": [
{
"address_1": "1601 W Reynolds St Ste 201",
"address_purpose": "LOCATION",
"city": "Plant City",
"state": "FL",
"postal_code": "335634747",
"country_code": "US",
"telephone_number": "813-874-5500",
"fax_number": "813-874-5505",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PINNACLE HEALTH GROUP PA",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-22",
"last_updated": "2022-03-31",
"certification_date": "2022-03-31",
"status": "A",
"authorized_official_last_name": "DIASTI",
"authorized_official_first_name": "SAM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "813-874-5500",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME71925",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "TAMPA",
"affiliation": "N",
"endpointDescription": "EHR",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2605 W Swann Ave",
"address_2": "Ste 100",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336094039",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.